Bosses said the policy, which also covers e-cigarettes, follows national guidance and patients will instead be offered nicotine replacement therapy, such as patches or chewing gum.

But staff and campaigners have raised serious concerns, saying the ban could lead to increased agitation, aggression and violence on the wards.

One nurse, who asked not to be named for fear of being disciplined, said: “What I have observed so far is a significant increase in patient harm due to the ban. Violence has increased, with emotional distress and frustration subsequently having a detrimental effect on patients.

“Staff are frightened to enforce the rule and this is leading to forcibly taking lighters from service users to try and avoid using restraint.”

The whistleblower said some staff have been ‘turning a blind eye’ to patients continuing to smoke in outdoor areas, but are then being threatened with disciplinary action for doing so.

Patients in secure facilities have reportedly complained of being treated unfairly, as other NHS users are able to leave the premises to smoke.

The policy, which was introduced last week, applies to all sites run by Lancashire Care NHS Foundation Trust, including the Pendleview Unit at the Royal Blackburn Hospital, and several wards at Burnley General.

It has already been introduced at many acute hospitals, but smoking is far more common among psychiatric patients, and Lancashire Care is one of the first mental health trusts to introduce a blanket ban.

Before last week, patients in secure wards would be escorted into a garden area for cigarette breaks.

“Nicotine replacement therapy is all well and good for anyone who has the willpower and a strong desire to quit smoking, but these are vulnerable patients, many of whom will use smoking as a coping mechanism. Support should be available to enable these patients to make their own choices.”

Lancashire Care claimed the policy was supported by ‘a majority’ of staff, but failed to provide any evidence to show this, including a staff survey which it said ‘needs more analysis’.

The trust also pointed to guidance from the National Institute Health and Care Excellence (NICE) which supports the policy, as well a successful implementation at a mental health trust in London, where it was said to have contributed to a reduction in violence.

Max Marshall, medical director, added: “As a health organisation it is our duty to support people to increase healthy behaviours including stopping smoking.

“Our inpatient wards have increased their therapeutic activities which enables staff to spend more time on the wards with service users, rather than escorting them on smoking breaks.

“We understand that there has been concerns about increased violence on the wards, however as part of the implementation we have engaged with other mental health trusts who have implemented a smokefree policy within their inpatient settings.

“The evidence does not show an increase in incidents, nor does it show that service users have refused an admission as a result of the wards being smokefree.”

East Lancashire Hospitals NHS Trust already uses the policy, although the Lancashire Telegraph has repeatedly highlighted the problem of hospital patients flouting the rules by smoking at the main entrance of the Royal Blackburn Hospitals.

This website and associated newspapers adhere to the Independent Press Standards Organisation's Editors' Code of Practice. If you have a complaint about the editorial content which relates to inaccuracy or intrusion, then please contact the editor here. If you are dissatisfied with the response provided you can contact IPSO here